Former research showed elevated values of ACE serum activity and ET-1 serumconcentration in liver cirrhosis. Experiments also proved elevated ACE serum activity inchronic hepatitis, except for ET-1. There is no data in literature due to interaction betweenACE and ET-1, neither their relationship with Doppler determined parameters hemodynamicstatus in blood circulation of patients with chronic liver diseases which was the subject of thisinvestigation.The research included all together 70 patients divided due to pathohistologicalexamination of biopsy obtained liver tissue divided in three groups. In Group I were includedpatients with liver steatosis, which showed pore fibrosis; group II, contained patients withalcohol and chronic virus hepatitis and primary biliary cirrhosis (PBC), diseases whichshowed moderate fibrosis and group III, were patients with alcohol liver disease on whichsamples of liver tissue prevailated cirrhosis. ACE serum activity was determined by OlympusAU 2700, kit «Infnity TM ACE Liquid Stable Reagent» for determine angiotensin convertingenzyme company Thermo Electron Corporation was used. This procedure of determing ACEserum activity was based on reaction described by Holmquist and associates.Results were expressed in units per liter (U/L). ET-1 serum concentration wasdetermined by ELISA test using reagens ASYBUF for ET-1. Results were expressed inpg/ml of serum.Experiment results showed increase of ACE and ET-1 serum activity in all patientswith various stages of chronic liver lesions what correlates with previous papers. Increase ofACE and ET-1 serum activity in patients is proportional to stage liver disease. The lowestACE activity were found in patients with liver steatosis and poor fibrosis (group I) - median,range: 57, 16-94 IU/L, while in patients with most severe liver fibrosis – cirrhosis (group III)ACE activity was the highest - median, range: 89, 65-139 IU/L. ET-1 serum concentrationalso shows distribution which follows stage of illness, similar as ACE serum activity. The103
lowest ET-1 concentration were noticed in u serum of patients with low and moderate fibrosis(group I) - median 6,25 pg/mL, range 2,38-11,80 pg/mL, while the highest concentration wasdetermined in patients with liver cirrhosis (group III) - median, range: 18,95, 12,05-59,38pg/mL. ACE serum activity shows emphasized increase in transition of liver fibrosis frompoor to moderate while ET-1 serum concentration shows marked increase in emerging livercirrhosis from moderate fibrosis. Border value of ACE serum activity which separatespatients with poor liver fibrosis from patients with moderate liver fibrosis is 59,0 U/I. Bordervalue of ET-1 serum activity which separates patients with poor and moderate liver fibrosisfrom patients with liver cirrhosis is 12,4 pg/ml. Correlation of ACE serum activity and ET-1serum concentration was examined by Spearman test in correlation range. Analysis showedpositive correlation of these two variables: with increase ACE serum activity there was alsofound increase of ET-1 serum concentration (p=0,004). RI flow through liver artery is thelowest among the patients with lighter form of poor liver fibrosis (group I): - median, range:0,65, 0,32-0,89 among patients with liver cirrhosis, (group III) -median, range: 0,81, 0,71-0,91. TAMV flow in portal vein shows values reversed association to scale of liver disease: ingroup I the highest values of TAMV were found - median, range: 18,60, 14,50-21,30 cm/s. Inpatients with heavier form of liver illness and cirrhosis (group III), TAMV values were thelowest - median, range: 12,50, 7,50-17,20 cm/s. ET-1serum concentrations showed positivecorrelation with RI ( p
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SVEUČILIŠTE U ZAGREBUMEDICINSKI F
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POPIS KRATICAACEangiotenzin konvert
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3. ISPITANICI i METODE.............
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1.1. RENIN ANGIOTENZIN SUSTAV (RAS)
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Slika 2. "Novi" koncept klasičnog
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1.1.1. AngiotenzinogenSupstrat reni
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i renina nađene su i u neferktomir
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Snižena plazmatska aktivnost renin
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Slika 3. Shematski prikaz krvožiln
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Izvanplućna konverzija angiotenzin
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Radovi Osborna i Studera (65,66) i
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Naša su istraživanja pokazala da
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1.1.7. Angiotenzin (1-7)Angiotenzin
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(114,115). Sve je više dokaza za p
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Slika 6. Mehanizam djelovanja endot
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Strukturno vrlo sličan ljudskim en
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afinitetom receptora (135). Cistein
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Uloga endotelina u patofiziologiji
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1.2.3.1. Učinci na kardiovaskularn
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1.2.4.2. Učinci ET-1 na regulaciju
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učinkom prostaglandin E2 relaksira
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subendotelijalnom prostoru. Naime,
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U in vivo uvjetima, neaktivne KC zd
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Molekularnim pristupom u istraživa
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s maksimumom nakon 48 sati (nakon g
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